Researchers Identify Widespread Use of Opioids in Nonsurgical Patients

Thursday, November 14, 2013

Researchers Identify Widespread Use of Opioids in Nonsurgical Patients

A study of more than 1 million adult hospital admissions has revealed a high rate of opioid prescriptions for nonsurgical patients, with over 43% receiving the medications during their stay, and over half of that population receiving opioids on the day of discharge. Researchers also identified a pattern of high-dosage prescription and significant regional variations.

In the study, researchers reviewed records of nonsurgical admissions between 2009 and 2010 from 286 nonfederal acute care hospitals. Authors found that 43% of the 1.14 million nonsurgical patients received opioids, with the average dose equivalent to about 68 milligrams of oral morphine per day. Additionally, researchers identified spikes in use: of the patients receiving opioids, 23% received dosages of 100 milligrams or more on at least 1 day of hospitalization. The research was conducted by a team from Beth Israel Deaconess Medical Center and published online November 13 in the Journal of Hospital Medicine.

The use of opioids was not confined to the days of hospitalization, according to the research, which found that 26% of patients were also administered opioids on the day of discharge. Authors believe that the common practice of tapering patients off these drugs means that as many of half of these patients also received a prescription for opioid medication to be taken after discharge.

The study also identified variations in use among hospitals in different parts of the country, with hospitals in the West reporting an opioid use rate about 37% higher than use rates in the Northeast, which reported the lowest rate. In addition, researchers found a correlation between frequency of prescription and risk of opioid-related complications.

A significant portion of nonsurgical hospital admissions are for patients with musculoskeletal injuries, and physical therapists (PTs) must often assess the impact of opioids and other pain medications on early mobility in the hospital as well as on later interventions. APTA offers several resources on this topic, including a 2-part course on the drugs used to treat pain and inflammation, and research on opioids and exercise available via the PT Now portal.